At PsychLaw.net we know that the expectations of mental health professionals can lead them to believe that symptoms consistent with their diagnostic impressions were exhibited in an interview; when in fact, they were not. Conversely, they are also less likely to recall symptoms that were actually present during an interview but inconsistent with their diagnostic impressions.
These effects of selective memory were dramatically demonstrated in a 1979 experiment using college students. The students read a story about a woman who exhibited both introverted and extroverted traits. Two days later, half of the students were asked to assess how well this woman would do in a sales position ‑ a presumably extroverted career. The remaining students were asked to assess her suitability as a librarian ‑ a presumably introverted career. Those students asked to assess how the woman would function as a salesperson interpreted more storyline facts as instances of her extroversion. Those students asked to assess how the woman would function as a librarian interpreted more storyline facts as instances of her introversion.
When confronted with evidence demonstrating the wholesale unreliability of their clinical judgment, mental health professionals protest vehemently. They insist they accurately remember how they question their patients, and how those patients respond to their questions. The relevant research, however, does not support such claims[1]. A 1981 study videotaped psychiatric trainees interviewing patients. The supervisory sessions of these trainees were also videotaped. Reviewing the videotapes revealed that the psychiatric trainees overlooked 50% of the important issues transpiring during their interviews. Furthermore, another 50% of what these trainees did report to their supervisors was also distorted. These data suggest that the total accuracy with which a typical interview is recalled approximates 25% (.50 x .50 = .25).
Experienced mental health professionals can be expected to protest the above study, insisting it is not applicable to them. They would likely claim that their years of professional experience enable them to avoid such errors. However, the relevant research does not support these claims either. Instead, the data demonstrate that experienced interviewers do not accurately recall their own behavior during interviews[2]. We at PsychLaw.net understand this is not particularly surprising considering how these professionals pay more attention to what their patients say than paying attention to themselves.
When asked exactly how they worded the questions they asked patients, mental health professionals cannot reply accurately. The relevant research demonstrates that our verbatim memory for conversational dialogue fades within seconds[3]. People then compensate for faded verbatim memories by using gap‑filling strategies[4]. In other words, they fill in their memory gaps with what seems plausible[5]. Nevertheless, they genuinely think they possess verbatim recall for what was said.
At PsychLaw.net we teach that the diagnostic impressions of mental health professionals can also lead them into selective recall of their interviews[6]. After reaching a diagnostic impression, for example, mental health professionals often incorrectly recall the patient exhibiting some symptom if that symptom is consistent with their diagnostic impression. Conversely, they also find it difficult to recall symptoms actually exhibited by the patient, but inconsistent with their diagnostic impressions. This kind of selective recall is known as “confirmatory bias,” defined as “… the tendency to seek supportive data for one’s hypotheses and to underweight or disregard non-supportive data.”[7]
Footnotes
[1]. Muslin, H.L., Thurnblad, R.J., Meschel, G. (1981). The fate of the clinical interview: An observational study. American Journal of Psychiatry, 138, 823-825.
[2]. Truax, C.B. (1966). Reinforcement and non-reinforcement in Rogerian psychotherapy. Journal of Abnormal Psychology, 71, 1-9.
[3]. Rayner, K. & Pollatsek, A. (1989). The psychology of reading. Englewood Cliffs, NJ: Prentice-Hall.
[4]. Roediger, H.L. III & McDermott, K.B. (1995). Creating false memories: Remembering words not presented in lists. Journal of Experimental Psychology: Learning, Memory and Cognition, 21, 803-814.
[5]. Barclay, C.R. & Wellman, H.M. (1986). Accuracies and inaccuracies in autobiographical memories. Journal of Memory and Language, 25, 93-103.
[6]. Arkes, H.R. & Harkness, A.R. (1980). Effect of making a diagnosis on subsequent recognition of symptoms. Journal of Experimental Psychology, 6, 99-105.
[7]. Faust, D. (1989). Data integration in legal evaluations: Can clinicians deliver on their premises? Behavioral Sciences & the Law, 7, 469-483 (p. 475).